Visual presentation of age differences in relative survival of hematological neoplasms in Sweden and the neighboring countries

TL;DR

This study compares age-related survival differences for blood cancers in Sweden and neighboring countries, finding that survival gaps have widened for some cancers but narrowed for others.

Contribution

The paper introduces a new method for visualizing and comparing age-group-specific survival differences in hematological malignancies across countries.

Findings

Age-related survival differences increased for AML and MM but decreased for other HMs over time.

Finnish male CLL and female MPD patients showed larger survival deviations due to older patients' outcomes.

Venetoclax is highlighted as a successful treatment for older patients in reducing age gaps.

Abstract

For many hematological malignancies (HMs) survival among older patients is compromised. We want to test the most up-to-date age-group-specific survival differences in five hematological malignancies, Hodgkin lymphoma (HL), multiple myeloma (MM), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML) and myeloproliferative diseases (MPD) in Sweden (SE) and compared these to Denmark, Finland and Norway. For analysis we apply a recently published metric for comparing and visualizing age-group-specific relative survival differences using data from the NORDCAN database between 1972 and 2021. Periodic changes in age-related deviation in SE survival showed increasing differences for AML and MM while for the other HMs the differences declined in the course of time. Country-specific differences were observed, for Finnish male CLL and female MPD deviations were larger than those for the other countries, both of which were explained by the deviant survival of the oldest patients. Age-related deviations in 5-year survival increased for AML and MM for which survival improvements have been achieved through intense treatment regimens but these are not offered to old patients because of risk of complications. Paradoxically, improving overall survival in AML and MM has contributed to the widening of the age gaps. For the remaining HMs, age-related deviations declined with time as even old patients benefitted from the survival improvements; most notably female MPD and CLL patients had hardly any age gaps. Age disparities are an issue in hematological malignancies, and an intense search for novel treatments also includes old patients with an example of success as a novel drug venetoclax.

The online version contains supplementary material available at 10.1007/s00277-025-06291-4.

Figures